Important Notice
This site is for informational purposes only and is intended to address medical questions from healthcare professionals in the United States.
To report an adverse event, e-mail drugsafety@pacira.com or dial 1-855-RX-EXPAREL (1-855-793-9727). For medical inquiries related to EXPAREL, submit a request to Medical Information or call 1-855-RX-EXPAREL (1-855-793-9727).
EXPAREL is indicated for single-dose infiltration in adults to produce postsurgical local analgesia
and as an interscalene brachial plexus nerve block to produce postsurgical regional analgesia.
Safety and efficacy have not been established in other nerve blocks.
Important Safety Information
EXPAREL is contraindicated in obstetrical paracervical block anesthesia.
Adverse reactions reported with an incidence greater than or equal to 10% following EXPAREL
administration via infiltration were nausea, constipation, and vomiting; adverse reactions reported with
an incidence greater than or equal to 10% following EXPAREL administration via interscalene brachial
plexus nerve block were nausea, pyrexia, and constipation.
If EXPAREL and other non-bupivacaine local anesthetics, including lidocaine, are administered at the
same site, there may be an immediate release of bupivacaine from EXPAREL. Therefore, EXPAREL may
be administered to the same site 20 minutes after injecting lidocaine.
EXPAREL is not recommended to be used in the following patient population: patients <18 years old
and/or pregnant patients.
Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL
should be used cautiously in patients with hepatic disease.
Warnings and Precautions Specific to EXPAREL
Avoid additional use of local anesthetics within 96 hours following administration of EXPAREL.
EXPAREL is not recommended for the following types or routes of administration: epidural, intrathecal,
regional nerve blocks other than interscalene brachial plexus nerve block, or intravascular or intraarticular use.
The potential sensory and/or motor loss with EXPAREL is temporary and varies in degree and duration
depending on the site of injection and dosage administered and may last for up to 5 days, as seen in
clinical trials.
Warnings and Precautions for Bupivacaine-Containing Products
Central Nervous System (CNS) Reactions: There have been reports of adverse neurologic reactions with the use of local anesthetics.
These include persistent anesthesia and paresthesia. CNS reactions are
characterized by excitation and/or depression. characterized by excitation and/or depression.
Cardiovascular System Reactions: Toxic blood concentrations depress cardiac conductivity and
excitability which may lead to dysrhythmias, sometimes leading to death.
Allergic Reactions: Allergic-type reactions (eg, anaphylaxis and angioedema) are rare and may occur as a
result of hypersensitivity to the local anesthetic or to other formulation ingredients.
Chondrolysis: There have been reports of chondrolysis (mostly in the shoulder joint) following intraarticular
infusion of local anesthetics, which is an unapproved use.
Methemoglobinemia: Cases of methemoglobinemia have been reported with local anesthetic use.
Please refer to full Prescribing Information